title: Lower urinary tract symptoms in female patients with pelvic organ prolapse: efficacy of pelvic floor reconstruction.
abstract: OBJECTIVE
  To evaluate the impact of pelvic floor reconstruction on lower urinary tract symptoms in patients with pelvic organ prolapse.
  
  
  METHODS
  We carried out a prospective study at a single institution. A total of 223 female patients who underwent tension-free vaginal mesh surgery for pelvic organ prolapse between January 2006 and February 2010 were enrolled and prospectively evaluated. A total of 171 cases with concurrent stress urinary incontinence (76% of all cases) underwent concomitant transobturator tape sling. For evaluation of lower urinary tract symptoms, parameters included International Prostate Symptom Score, its quality of life score, International Consultation on Incontinence Questionnaires Short Form, overactive bladder questionnaire, maximal flow rate and postvoid residual. These parameters were evaluated at baseline, and at 3, 6 and 12 months after the surgery.
  
  
  RESULTS
  The severity of International Prostate Symptom Score total scores significantly correlated with preoperative pelvic organ prolapse quantification stages, overactive bladder questionnaire total scores and International Consultation on Incontinence Questionnaires Short Form scores. A total of 37% of stage 4 showed ≥20 International Prostate Symptom Score (severe cases). Postvoid residual significantly increased in stage 4 compared with stage 2. Tension-free vaginal mesh improved International Prostate Symptom Score, overactive bladder questionnaire and International Consultation on Incontinence Questionnaires Short Form significantly, and also achieved grade 0 pelvic organ prolapse quantification in 91% of all cases at 1 year after surgery. Postvoid residual values significantly improved and remained stable for 1 year. Worse overactive bladder questionnaire score was a significant predictive factor for poor postoperative International Prostate Symptom Score.
  
  
  CONCLUSIONS
  The tension-free vaginal mesh plus transobturator tape procedure improves lower urinary tract symptoms in the majority of patients presenting pelvic organ prolapse.
authors.affiliation: Department of Urology, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Obinata
authors.forename: Kenya
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Akiko
authors.initials: A
authors.lastname: Ito
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Murata
authors.forename: Daisaku
authors.initials: D
authors.lastname: Ashikari
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Igarashi
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Sato
authors.forename: Junichi
authors.initials: J
authors.lastname: Mochida
authors.forename: Yataro
authors.initials: Y
authors.lastname: Yamanaka
authors.forename: Satoru
authors.initials: S
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000209:etiology* / Q000601:surgery*; D017773:Pelvic Floor / Q000601:surgery*; D056887:Pelvic Organ Prolapse / Q000150:complications* / Q000601:surgery*; D011446:Prospective Studies; D053825:Suburethral Slings; D013526:Surgical Mesh; D011795:Surveys and Questionnaires
keywords: lower urinary tract symptoms; pelvic organ prolapse; quality of life; tension-free vaginal mesh